Australian Government - Department of Health - Office of Hearing Services
Hearing Services Program

Provider Factsheet 5 - Claiming information when selling or buying a hearing service business

When a service provider sells their business to another service provider there are often claims that need to be submitted outside of the normal methods and systems. The information below can assist providers to navigate the correct systems of submission to ensure the claims are approved and paid.

Selling Service Provider

The selling provider must ensure their e-Claim System = Claim Wizard, Hear Aid, VicHear or Simply Hearing remains open until all claimable items are submitted successfully.

The selling service provider should review client files and if you identify any claims made in error they should be recovered and any correct claims should be submitted immediately through the Hearing Services Online Portal = HSO portal before your business closure date and transfer of clients. The selling provider will not be able to access client records on the HSO portal from the date of closure.

The selling provider must ensure all claims have been submitted no later than 28 business days after the date of closure.

All assessment claims should be submitted within 10 business days, through the selling provider e-Claim system. 

It is recommended that the selling provider does not provide a fitting if they cannot complete a follow up appointment before the date of closure.

The selling business should not accept battery and maintenance payments by the client nor can they claim an item 630/631 or 640/641 as you will not be providing maintenance services to the client.  Clients should be refunded their contribution and advised to take up the Battery and Maintenance Agreement with the buying service provider.

If the selling provider does complete a fitting but cannot complete the follow up appointment, the selling and buying provider will need to submit split payment claims.

There are two parts to a split payment

  • Part 1 is submitted by the selling provider where the fitting date is prior to the Date of Transfer and no follow-up has occurred (see Table 1) and
  • Part 2 is submitted by the buying provider where a follow-up has been completed on the devices fitted by the selling service provider (see Table 2, and 3A or 3B).

The selling service provider should contact the program as soon as possible if you require assistance understanding the process. The claims for payment form for the non-follow-up appointment must be emailed to hearing@health.gov.au within the 28 days of the closure date.  Please refer to Claiming through the portal for information on submitting claims correctly.

Table 1 - Claiming when a service provider transfers their contract or sells their business

Submitting Claims

Sellers action

Item Number

The assessment date is prior to the Date of Transfer e-Claim using an appropriate system 600 or 800

The fitting and follow-up dates are prior to the Date of Transfer

 

e-Claim using an appropriate system

Monaural Item:

650, 630 or 820

Binaural:

660, 640 or 830

 

The assessment date is after the Date of Transfer No action N/A

The fitting and follow-up date are after the Date of Transfer

 

No action N/A

The fitting date is prior to the Date of Transfer where the client has not attended a follow-up appointment and no follow-up service has been provided.

 

Attach the claim form and email it to hearing@health.gov.au.

The subject line should be displayed as:

SP# – voucher # – client name – item # – SP business transfer

Monaural Item:

651, 771 or 821

Binaural Item:

661 or 831

 

The follow-up date of service is after the Date of Transfer

 

No action N/A

Buying Service Provider

Once the selling service provider has submitted their no-follow-up claim successfully, the buying provider can attach the item 6 claim form by email to hearing@health.gov.au to cover the costs of the follow up/rehabilitation component of the fitting.

The follow-up date of service must be after the date of transfer.

As part of the termination agreement, the buying service provider is not able to claim for relocated maintenance (item 711 or 722). If the client wishes to enter into a battery and maintenance agreement, the buying provider can claim an item 700/710 if the client has been fitted for the first time through the program or when their current maintenance agreement expires.

Please refer to the Table 2, Table 3A and 3B to assist you with submitting your claims correctly.

Table 2 - Claiming when buying an existing hearing service business

Submitting Claims

Buyers action

Item Number

The assessment date is prior to the Date of Transfer No action N/A

The fitting and follow-up dates are prior to the Date of Transfer

 

No action N/A
The assessment date is after the Date of Transfer e-Claim using an appropriate system 600 or 800

The fitting and follow-up date are after the Date of Transfer

 

e-Claim using an appropriate system

Monaural Item:

650, 630 or 820

Binaural Item:

660, 640 or 830

The fitting date is prior to the Date of Transfer where the client has not attended a follow-up appointment and no follow-up service has been provided. No action N/A
The follow-up date of service is after the Date of Transfer

Attach the claim form and email it to hearing@health.gov.au.

The subject line should be displayed as:

SP# – voucher # – client name – item # – SP business transfer

Exception Item:

6 (follow-up completion)

Refer to Table 3A or 3B

Table 3A – Item 6 (Split Payment) Amount for the 2018-2019 Financial Year

Item 6 submitted by the buying Service Provider

Item Benefit (Liable for GST)

Item Benefit (Not liable for GST)

Total amount payable

Item 6 - split payment

  • 651 claimed by the selling SP

n/a

$217.20

$217.20

Item 6 – split payment

  • 661 claimed by the selling SP

n/a

$260.50

$260.50

Item 6 – split payment

  • 771 claimed by the selling SP

n/a

$41.15

$41.15

Item 6 - split payment

  • 821 claimed by the selling SP

n/a

$186.65

$186.65

Item 6 - split payment

  • 831 claimed by the selling SP

n/a

$185.50

$185.50

Table 3B – Item 6 (Split Payment) Amount for the 2017-2018 Financial Year

Item 6 submitted by the buying Service Provider

Item Benefit (Liable for GST)

Item Benefit (Not liable for GST)

Total amount payable

Item 6 - split payment

  • 651 claimed by the selling SP

n/a

$214.20

$214.20

Item 6 – split payment

  • 661 claimed by the selling SP

n/a

$256.90

$256.90

Item 6 – split payment

  • 771 claimed by the selling SP

n/a

$40.60

$40.60

Item 6 - split payment

  • 821 claimed by the selling SP

n/a

$184.05

$184.05

Item 6 - split payment

  • 831 claimed by the selling SP

n/a

$182.95

$182.95

 

PF5 - Claiming information when selling or buying a hearing service business (PDF) (PDF 95 KB)

Provider Factsheets

Claiming through the portal

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